Perimenopause is the time during which your body prepares for menopause; sometimes people refer to perimenopause as the menopausal transition period. The issue with perimenopause is that women start seeing the progression towards menopause at different ages. Some begin noticing perimenopause as early as their mid-30s, with most women experiencing the symptoms toward their 40s.
During perimenopause, levels of estrogen are constantly fluctuating, which leads to the common perimenopause symptoms. However, in many cases, women confuse symptoms such as hot flashes and night sweats with menopause signs, when in reality their body is entering perimenopause.
Perimenopause causes ovulation cycles to vary widely. The length between periods might shorten or lengthen, as well as the intensity of the periods. During perimenopause women often notice they may skip some periods from time to time. When women experience a change of seven days or more on their menstrual cycle, that means they are in early perimenopause. When there is a space of 60-days or more between periods, these are signs of late perimenopause.
The sleep problems most women report during perimenopause are a result of the night sweats and hot flashes experienced while sleeping. However, sleeping problems can arise even without these other perimenopause symptoms.
Changes in Libido
During perimenopause, sexual function may change. However, this is most likely a result of altered sleep patterns and chronic fatigue. Hormonal shifts also contribute to a decreased libido. Although, during perimenopause those women who had satisfactory sexual intimacy before onset will likely continue through menopause and beyond.
Bladder and Vaginal Problems
Due to fluctuating estrogen levels, vaginal tissues tend to lose elasticity and lubrication during perimenopause, which may lead to painful intercourse. Low estrogen levels also raise the risks of urinary and vaginal infections. Eventually, loss of vaginal tissue may lead to urinary incontinence and other bladder problems.
Changes in Cholesterol
Most women don’t associate changes in cholesterol with perimenopause symptoms. But, in reality, declining estrogen levels can lead to an increase in low-density lipoprotein (LDL) cholesterol – AKA “bad” cholesterol – which increases risks of heart disease.
Loss of Bone Density
Declining estrogen levels are connected to bone loss. During perimenopause, women are more susceptible to develop osteoporosis, a disease that leads to fragile bones. Low estrogen levels alter the metabolism of bone, which means the calcium leaving the bone at any given time is not being replaced entirely.
Estrogen fluctuations can contribute to fluid retention. Estrogen production also affects appetite control, increasing hunger. Many women experience bloating during perimenopause and it is not uncommon for women to experience significant weight gain, especially in the belly region, during perimenopause.
Perimenopause marks the start of a decline in fertility. As ovulation becomes more irregular, the ability to conceive decreases. However, during perimenopause, women still get periods, which means pregnancy is possible. Those looking to avoid pregnancy should remain using some form of birth control until they’ve had no periods for 12 months, indicating they’ve fully entered menopause.
There is Relief for Perimenopause Symptoms
Thanks to a functional approach to medicine, perimenopause signs such as irregular periods, libido decrease, hot flashes, anxiety, and others can be managed. Functional medicine resorts to the use of bioidentical hormone replacement therapy (HRT) and other treatments for female sexual health that can help improve perimenopause symptoms.